Provider Demographics
NPI:1023854502
Name:JOSEPH BODY WORKS LLC
Entity type:Organization
Organization Name:JOSEPH BODY WORKS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:SUZANNE JOSEPH
Authorized Official - Last Name:KUPISZEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-219-0091
Mailing Address - Street 1:1608 W COLONIAL PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60067-4755
Mailing Address - Country:US
Mailing Address - Phone:630-219-0091
Mailing Address - Fax:630-219-0029
Practice Address - Street 1:1608 W COLONIAL PKWY STE 105
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:IL
Practice Address - Zip Code:60067-4755
Practice Address - Country:US
Practice Address - Phone:630-219-0091
Practice Address - Fax:630-219-0029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-03
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy